Sanctuary Life Care Limited

Sanctuary Life Care Limited is a domiciliary care service providing personal care to people in their own homes. These can be older people or younger adults living with a learning disability or autistic spectrum disorder, dementia, a physical disability, mental health or sensory impairment. At the time of the inspection one person received personal care.

Not everyone who uses the service may receive personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

This was a targeted inspection that considered management of risks and the quality and safety of the service within Safe and Well Led key questions. Based on our inspection of these areas, we found improvements were still required.

Audits systems continued not to be fully effective in identifying areas needing improvement to ensure the quality and safety of the service was maintained. The lack of robust governance had resulted in the failure to identify the issues that we found. We have made a recommendation about seeking additional guidance around regulatory requirements to help improve the governance of the service.

Risks associated with people’s needs were not always assessed to ensure staff had the information they needed to provide safe and consistent care. Accessibility to records to evidence care and safe practice continued to need improvement. There had been some improvement to medicine records to confirm how they were managed but further improvement was needed.

Staff recruitment information did not follow the providers recruitment policy to ensure staff were safe, and suitable, to work with people. Training records were not sufficient in detail to show staff were suitably trained to support people. Positive comments were received from a person using the service. Staff felt supported by the registered manager and deputy manager.

Following our feedback, the provider told us of action taken to address any immediate risks.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 3 November 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 12, 17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. This related to specific concerns we had about access to records, policies and procedures not being followed, care planning, medicine management and recruitment practices. The overall rating for the service has not changed following this targeted inspection and remains inadequate.

We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Enforcement and Recommendations

We have identified continued breaches in relation to Regulation 12 Safe care and treatment, Regulation 17 Good Governance and Regulation 19 Fit and proper persons employed, at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Sanctuary Life Care Limited is a domiciliary care service providing personal care to people in their own homes. These can be older people or younger adults living with a learning disability or autistic spectrum disorder, dementia, a physical disability, mental health or sensory impairment. At the time of the inspection three people received personal care.

Not everyone who uses the service may receive personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

People’s individual risks were not always identified, assessed and well-managed. The provider could not demonstrate all planned care had been provided safely because records were not always completed accurately or clearly, to demonstrate safe practice and enable effective monitoring to take place.

Medicines were not always managed safely because some were administered without any medicine administration plans to guide staff on how to do this. Staff recruitment and training records were not sufficient in demonstrating staff were safe, and suitable to work with people.

At the time of our inspection there were enough staff to meet people's needs. Whilst staff knew the people they provided personal care to well, care records were not always in place to help ensure they provided personalised and responsive care.

The provider had failed to operate systems or processes to assess, monitor and improve the quality and safety of the service provided. Audits and checks could not be demonstrated, and the system used to gather feedback about the service from people and their families was ineffective. The lack of robust governance had resulted in the failure to identify the issues that we found.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported during care calls with food and drinks where needed.

People using the service felt safe. Relatives felt the registered manager and staff were kind and respectful and confirmed care calls were made at times they expected. They knew who to speak with if they had any concerns. Staff felt supported by the provider who was also the registered manager of the service

Following our feedback, the provider told us they had taken action to manage risks and had planned action to improve standards and practice at the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection

This service was registered with us on 3 September 2018 and this is the first inspection. The service began providing a personal care service from April 2021.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to Safe care and treatment, Fit and proper persons employed, Safeguarding service users from abuse and improper treatment, and Good governance at this inspection.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.